Plastic surgery could ease migraines for those desperate for relief

Mar. 5, 2014

Kevin Delaney, a plastic and reconstructive surgeon and head of the new advanced migraine surgery program at the Medical University of South Carolina in Charleston, has a possible solution for some patients who are desperate for relief: Botox or surgery. / Sarah Bates Pack/MUSC

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Imagine spending days in a dark, quiet room, suffering with excruciating headache pain. Migraines can be debilitating, causing sufferers to miss the joy in everyday life.

As many as 30 percent of women experience migraines at some point in their life. And for many, they can be a source of chronic pain.

Kevin Delaney, a plastic and reconstructive surgeon and head of the new advanced migraine surgery program at the Medical University of South Carolina in Charleston, has a possible solution for some patients who are desperate for relief: Botox or surgery.

First, however, patients should see a physician who specializes in headaches.

“It is of primary importance for patients who think it’s a migraine to go to a headache specialist,” Delaney said. “That’s most commonly a neurologist. The goal is to get a correct diagnosis.”

“On the scale of headaches, people usually describe it as the worst headache they’ve ever had,” Delaney said. “Often, they have visual changes — blurry vision or seeing spots. Some people say they have different smells when the headache is starting. Even little noises will aggravate them so much they can’t stand it.”

Migraines may also be accompanied by nausea and sensitivity to light.

“It impacts not just the patient, but the whole family,” Delaney says. “If moms have kids to take care of, sometimes they can’t function for hours or even days. It’s pretty significant for someone who has to take care of kids or miss work.”

Delaney said there are a variety of nonsurgical options that may offer relief, including medication, dietary modifications, exercise, acupuncture and chiropractic treatment.

“If medications aren’t working or have side effects, a lot of specialists actually treat with Botox,” Delaney said. “Botox was initially used for certain disorders of the eye. It is a temporary paralytic. It paralyzes the muscles you inject it into.”

And that can be the key for migraine sufferers who have been unable to find relief elsewhere.

“The nerves beneath the skin and scalp travel through muscle,” Delaney said. “Those nerves are getting pinched through tight areas of muscle. That nerve is the trigger point of where someone’s migraine begins.”

If the muscle isn’t contracting and pinching the nerve, the migraine isn’t triggered.

“The Botox is a temporary solution,” Delaney said. “Usually each dose is effective for three to four months. After multiple injections over the years, the efficacy of the Botox may begin to wear off.”

Though patients can use Botox for as long as it is effective, surgery is now an option for some. The surgery decompresses and releases the nerve being pinched, a result that Delaney likens to permanent Botox. For those in pain, specialists can give them a chance at a new life.

“There is a solution out there, but the surgery is not for everybody,” Delaney said.